Provider Demographics
NPI:1013343441
Name:GAI, MARISSA ELENA (MS CFY-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MARISSA
Middle Name:ELENA
Last Name:GAI
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20561 COLONIAL ISLE DR
Mailing Address - Street 2:#206
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3705
Mailing Address - Country:US
Mailing Address - Phone:954-552-2999
Mailing Address - Fax:
Practice Address - Street 1:4443 ROWAN RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6198
Practice Address - Country:US
Practice Address - Phone:727-846-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist